| NPI | 1770202517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LACEY MARIE FAUGHENDER Lcsw/ Owner 503-902-5930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2022-08-24 |
| Last Update Date | 2022-08-24 |